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Siffredi V, Liverani MC, Van De Ville D, Freitas LGA, Borradori Tolsa C, Hüppi PS, Ha-Vinh Leuchter R. Corpus callosum structural characteristics in very preterm children and adolescents: Developmental trajectory and relationship to cognitive functioning. Dev Cogn Neurosci 2023; 60:101211. [PMID: 36780739 PMCID: PMC9925611 DOI: 10.1016/j.dcn.2023.101211] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/08/2023] Open
Abstract
Previous studies suggest that structural alteration of the corpus callosum, i.e., the largest white matter commissural pathway, occurs after a preterm birth in the neonatal period and lasts across development. The present study aims to unravel corpus callosum structural characteristics across childhood and adolescence in very preterm (VPT) individuals, and their associations with general intellectual, executive and socio-emotional functioning. Neuropsychological assessments, T1-weighted and multi-shell diffusion MRI were collected in 79 VPT and 46 full term controls aged 6-14 years. Volumetric, diffusion tensor and neurite orientation dispersion and density imaging (NODDI) measures were extracted on 7 callosal portions using TractSeg. A multivariate data-driven approach (partial least squares correlation) and a cohort-based age normative modelling approach were used to explore associations between callosal characteristics and neuropsychological outcomes. The VPT and a full-term control groups showed similar trends of white-matter maturation over time, i.e., increase FA and reduced ODI, in all callosal segments, that was associated with increase in general intellectual functioning. However, using a cohort-based age-related normative modelling, findings show atypical pattern of callosal development in the VPT group, with reduced callosal maturation over time that was associated with poorer general intellectual and working memory functioning, as well as with lower gestational age.
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Affiliation(s)
- Vanessa Siffredi
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland; Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland; Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Switzerland.
| | - Maria Chiara Liverani
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland; SensoriMotor, Affective and Social Development Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Dimitri Van De Ville
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland; Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland; Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Switzerland
| | - Lorena G A Freitas
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland; Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland; Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Switzerland
| | - Cristina Borradori Tolsa
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Petra Susan Hüppi
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Russia Ha-Vinh Leuchter
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
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Neumane S, Gondova A, Leprince Y, Hertz-Pannier L, Arichi T, Dubois J. Early structural connectivity within the sensorimotor network: Deviations related to prematurity and association to neurodevelopmental outcome. Front Neurosci 2022; 16:932386. [PMID: 36507362 PMCID: PMC9732267 DOI: 10.3389/fnins.2022.932386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022] Open
Abstract
Consisting of distributed and interconnected structures that interact through cortico-cortical connections and cortico-subcortical loops, the sensorimotor (SM) network undergoes rapid maturation during the perinatal period and is thus particularly vulnerable to preterm birth. However, the impact of prematurity on the development and integrity of the emerging SM connections and their relationship to later motor and global impairments are still poorly understood. In this study we aimed to explore to which extent the early microstructural maturation of SM white matter (WM) connections at term-equivalent age (TEA) is modulated by prematurity and related with neurodevelopmental outcome at 18 months corrected age. We analyzed 118 diffusion MRI datasets from the developing Human Connectome Project (dHCP) database: 59 preterm (PT) low-risk infants scanned near TEA and a control group of full-term (FT) neonates paired for age at MRI and sex. We delineated WM connections between the primary SM cortices (S1, M1 and paracentral region) and subcortical structures using probabilistic tractography, and evaluated their microstructure with diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) models. To go beyond tract-specific univariate analyses, we computed a maturational distance related to prematurity based on the multi-parametric Mahalanobis distance of each PT infant relative to the FT group. Our results confirmed the presence of microstructural differences in SM tracts between PT and FT infants, with effects increasing with lower gestational age at birth. Maturational distance analyses highlighted that prematurity has a differential effect on SM tracts with higher distances and thus impact on (i) cortico-cortical than cortico-subcortical connections; (ii) projections involving S1 than M1 and paracentral region; and (iii) the most rostral cortico-subcortical tracts, involving the lenticular nucleus. These different alterations at TEA suggested that vulnerability follows a specific pattern coherent with the established WM caudo-rostral progression of maturation. Finally, we highlighted some relationships between NODDI-derived maturational distances of specific tracts and fine motor and cognitive outcomes at 18 months. As a whole, our results expand understanding of the significant impact of premature birth and early alterations on the emerging SM network even in low-risk infants, with possible relationship with neurodevelopmental outcomes. This encourages further exploration of these potential neuroimaging markers for prediction of neurodevelopmental disorders, with special interest for subtle neuromotor impairments frequently observed in preterm-born children.
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Affiliation(s)
- Sara Neumane
- Inserm, NeuroDiderot, Université Paris Cité, Paris, France
- CEA, NeuroSpin UNIACT, Université Paris-Saclay, Paris, France
- School of Biomedical Engineering and Imaging Sciences, Centre for the Developing Brain, King’s College London, London, United Kingdom
| | - Andrea Gondova
- Inserm, NeuroDiderot, Université Paris Cité, Paris, France
- CEA, NeuroSpin UNIACT, Université Paris-Saclay, Paris, France
| | - Yann Leprince
- CEA, NeuroSpin UNIACT, Université Paris-Saclay, Paris, France
| | - Lucie Hertz-Pannier
- Inserm, NeuroDiderot, Université Paris Cité, Paris, France
- CEA, NeuroSpin UNIACT, Université Paris-Saclay, Paris, France
| | - Tomoki Arichi
- School of Biomedical Engineering and Imaging Sciences, Centre for the Developing Brain, King’s College London, London, United Kingdom
- Paediatric Neurosciences, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Jessica Dubois
- Inserm, NeuroDiderot, Université Paris Cité, Paris, France
- CEA, NeuroSpin UNIACT, Université Paris-Saclay, Paris, France
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3
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Triplett RL, Smyser CD. Neuroimaging of structural and functional connectivity in preterm infants with intraventricular hemorrhage. Semin Perinatol 2022; 46:151593. [PMID: 35410714 PMCID: PMC9910034 DOI: 10.1016/j.semperi.2022.151593] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Preterm infants with intraventricular hemorrhage (IVH) are known to have some of the worst neurodevelopmental outcomes in all of neonatal medicine, with a growing body of evidence relating these outcomes to underlying disruptions in brain structure and function. This review begins by summarizing state-of-the-art neuroimaging techniques delineating structural and functional connectivity (diffusion and resting state functional MRI) and their application in infants with IVH, including unique technical challenges and emerging methods. We then review studies of altered structural and functional connectivity, highlighting the role of IVH severity and location. We subsequently detail investigations linking structural and functional findings in infancy to later outcomes in early childhood. We conclude with future directions including methodologic considerations for prospective and potentially interventional studies designed to mitigate disruptions to underlying structural and functional connections and improve neurodevelopmental outcomes in this high-risk population.
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Affiliation(s)
- Regina L Triplett
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Christopher D Smyser
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA; Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA; Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA.
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4
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Nieuwets A, Cizmeci MN, Groenendaal F, Leijser LM, Koopman C, Benders MJNL, Dudink J, de Vries LS, van der Aa NE. Post-hemorrhagic ventricular dilatation affects white matter maturation in extremely preterm infants. Pediatr Res 2022; 92:225-232. [PMID: 34446847 DOI: 10.1038/s41390-021-01704-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/20/2021] [Accepted: 08/08/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Data on microstructural white matter integrity in preterm infants with post-hemorrhagic ventricular dilatation (PHVD) using diffusion tensor imaging (DTI) are limited. Also, to date, no study has focused on the DTI changes in extremely preterm (EP) infants with PHVD. METHODS A case-control study of EP infants <28 weeks' gestation with PHVD was conducted. Diffusivity and fractional anisotropy (FA) values of corticospinal tracts (CST) and corpus callosum (CC) were measured using DTI at term-equivalent age. Outcomes were assessed at 2-years-corrected age. RESULTS Twenty-one infants with PHVD and 21 matched-controls were assessed. FA values in the CC were lower in infants with PHVD compared with controls (mean difference, 0.05 [95% confidence interval (CI), 0.02-0.08], p < 0.001). In infants with periventricular hemorrhagic infarction, FA values in the CC were lower than in controls (mean difference, 0.05 [95% CI, 0.02-0.09], p = 0.005). The composite cognitive and motor scores were associated with the FA value of the CC (coefficient 114, p = 0.01 and coefficient 147, p = 0.004; respectively). CONCLUSIONS Extremely preterm infants with PHVD showed lower FA values in CC. A positive correlation was also shown between the composite cognitive and motor scores and FA value of the CC at 2-years-corrected age. IMPACT Extremely preterm infants with post-hemorrhagic ventricular dilatation showed lower fractional anisotropy values in their corpus callosum compared with controls reflecting the impaired microstructure of these commissural nerve fibers that are adjacent to the dilated ventricles. Impaired microstructure of the corpus callosum was shown to be associated with cognitive and motor scores at 2-years-corrected age.
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Affiliation(s)
- Astrid Nieuwets
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University, Utrecht, The Netherlands.,Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mehmet N Cizmeci
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University, Utrecht, The Netherlands.,Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.,Division of Neonatology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Floris Groenendaal
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University, Utrecht, The Netherlands.,Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lara M Leijser
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University, Utrecht, The Netherlands.,Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.,Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Corine Koopman
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University, Utrecht, The Netherlands.,Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Manon J N L Benders
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University, Utrecht, The Netherlands.,Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University, Utrecht, The Netherlands.,Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Linda S de Vries
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University, Utrecht, The Netherlands.,Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Niek E van der Aa
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University, Utrecht, The Netherlands. .,Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
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5
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Yuan S, Liu M, Kim S, Yang J, Barkovich AJ, Xu D, Kim H. Cyto/myeloarchitecture of cortical gray matter and superficial white matter in early neurodevelopment: multimodal MRI study in preterm neonates. Cereb Cortex 2022; 33:357-373. [PMID: 35235643 PMCID: PMC9837610 DOI: 10.1093/cercor/bhac071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 01/19/2023] Open
Abstract
The cerebral cortex undergoes rapid microstructural changes throughout the third trimester. Recently, there has been growing interest on imaging features that represent cyto/myeloarchitecture underlying intracortical myelination, cortical gray matter (GM), and its adjacent superficial whitematter (sWM). Using 92 magnetic resonance imaging scans from 78 preterm neonates, the current study used combined T1-weighted/T2-weighted (T1w/T2w) intensity ratio and diffusion tensor imaging (DTI) measurements, including fractional anisotropy (FA) and mean diffusivity (MD), to characterize the developing cyto/myeloarchitectural architecture. DTI metrics showed a linear trajectory: FA decreased in GM but increased in sWM with time; and MD decreased in both GM and sWM. Conversely, T1w/T2w measurements showed a distinctive parabolic trajectory, revealing additional cyto/myeloarchitectural signature inferred. Furthermore, the spatiotemporal courses were regionally heterogeneous: central, ventral, and temporal regions of GM and sWM exhibited faster T1w/T2w changes; anterior sWM areas exhibited faster FA increases; and central and cingulate areas in GM and sWM exhibited faster MD decreases. These results may explain cyto/myeloarchitectural processes, including dendritic arborization, synaptogenesis, glial proliferation, and radial glial cell organization and apoptosis. Finally, T1w/T2w values were significantly associated with 1-year language and cognitive outcome scores, while MD significantly decreased with intraventricular hemorrhage.
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Affiliation(s)
| | | | | | - Jingda Yang
- Department of Neurology, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Anthony James Barkovich
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Duan Xu
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Hosung Kim
- Corresponding author: 2025 Zonal Ave, Los Angeles, CA 90033, USA.
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6
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Bruckert L, Shpanskaya K, McKenna ES, Borchers LR, Yablonski M, Blecher T, Ben-Shachar M, Travis KE, Feldman HM, Yeom KW. Age-Dependent White Matter Characteristics of the Cerebellar Peduncles from Infancy Through Adolescence. THE CEREBELLUM 2019; 18:372-387. [PMID: 30637673 DOI: 10.1007/s12311-018-1003-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Cerebellum-cerebrum connections are essential for many motor and cognitive functions and cerebellar disorders are prevalent in childhood. The middle (MCP), inferior (ICP), and superior cerebellar peduncles (SCP) are the major white matter pathways that permit communication between the cerebellum and the cerebrum. Knowledge about the microstructural properties of these cerebellar peduncles across childhood is limited. Here, we report on a diffusion magnetic resonance imaging tractography study to describe age-dependent characteristics of the cerebellar peduncles in a cross-sectional sample of infants, children, and adolescents from newborn to 17 years of age (N = 113). Scans were collected as part of clinical care; participants were restricted to those whose scans showed no abnormal findings and whose history and exam had no risk factors for cerebellar abnormalities. A novel automated tractography protocol was applied. Results showed that mean tract-FA increased, while mean tract-MD decreased from infancy to adolescence in all peduncles. Rapid changes were observed in both diffusion measures in the first 24 months of life, followed by gradual change at older ages. The shape of the tract profiles was similar across ages for all peduncles. These data are the first to characterize the variability of diffusion properties both across and within cerebellar white matter pathways that occur from birth through later adolescence. The data represent a rich normative data set against which white matter alterations seen in children with posterior fossa conditions can be compared. Ultimately, the data will facilitate the identification of sensitive biomarkers of cerebellar abnormalities.
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Affiliation(s)
- Lisa Bruckert
- Division of Developmental-Behavioral Pediatrics, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Katie Shpanskaya
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Emily S McKenna
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Lauren R Borchers
- Division of Developmental-Behavioral Pediatrics, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Maya Yablonski
- The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, 5290002, Ramat Gan, Israel
| | - Tal Blecher
- The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, 5290002, Ramat Gan, Israel
| | - Michal Ben-Shachar
- The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, 5290002, Ramat Gan, Israel.,Department of English Literature and Linguistics, Bar Ilan University, 5290002, Ramat Gan, Israel
| | - Katherine E Travis
- Division of Developmental-Behavioral Pediatrics, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Heidi M Feldman
- Division of Developmental-Behavioral Pediatrics, Stanford University School of Medicine, Stanford, CA, 94305, USA.
| | - Kristen W Yeom
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, CA, 94305, USA
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7
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Zöllei L, Jaimes C, Saliba E, Grant PE, Yendiki A. TRActs constrained by UnderLying INfant anatomy (TRACULInA): An automated probabilistic tractography tool with anatomical priors for use in the newborn brain. Neuroimage 2019; 199:1-17. [PMID: 31132451 PMCID: PMC6688923 DOI: 10.1016/j.neuroimage.2019.05.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 05/14/2019] [Accepted: 05/18/2019] [Indexed: 10/26/2022] Open
Abstract
The ongoing myelination of white-matter fiber bundles plays a significant role in brain development. However, reliable and consistent identification of these bundles from infant brain MRIs is often challenging due to inherently low diffusion anisotropy, as well as motion and other artifacts. In this paper we introduce a new tool for automated probabilistic tractography specifically designed for newborn infants. Our tool incorporates prior information about the anatomical neighborhood of white-matter pathways from a training data set. In our experiments, we evaluate this tool on data from both full-term and prematurely born infants and demonstrate that it can reconstruct known white-matter tracts in both groups robustly, even in the presence of differences between the training set and study subjects. Additionally, we evaluate it on a publicly available large data set of healthy term infants (UNC Early Brain Development Program). This paves the way for performing a host of sophisticated analyses in newborns that we have previously implemented for the adult brain, such as pointwise analysis along tracts and longitudinal analysis, in both health and disease.
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Affiliation(s)
- Lilla Zöllei
- Massachusetts General Hospital, Boston, United States.
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8
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Sparrow SA, Anblagan D, Drake AJ, Telford EJ, Pataky R, Piyasena C, Semple SI, Bastin ME, Boardman JP. Diffusion MRI parameters of corpus callosum and corticospinal tract in neonates: Comparison between region-of-interest and whole tract averaged measurements. Eur J Paediatr Neurol 2018; 22:807-813. [PMID: 29804802 PMCID: PMC6148214 DOI: 10.1016/j.ejpn.2018.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 03/28/2018] [Accepted: 05/11/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Measures of white matter (WM) microstructure inferred from diffusion magnetic resonance imaging (dMRI) are useful for studying brain development. There is uncertainty about agreement between FA and MD values obtained from region-of-interest (ROI) versus whole tract approaches. We investigated agreement between dMRI measures using ROI and Probabilistic Neighbourhood Tractography (PNT) in genu of corpus callosum (gCC) and corticospinal tracts (CST). MATERIALS AND METHODS 81 neonates underwent 64 direction DTI at term equivalent age. FA and MD values were extracted from a 8 mm3 ROI placed within the gCC, right and left posterior limbs of internal capsule. PNT was used to segment gCC and CSTs to calculate whole tract-averaged FA and MD. Agreement between values obtained by each method was compared using Bland-Altman statistics and Pearson's correlation. RESULTS Across the 3 tracts the mean difference in FA measured by PNT and ROI ranged between 0.13 and 0.17, and the 95% limits of agreement did not include the possibility of no difference. For MD, the mean difference in values obtained from PNT and ROI ranged between 0.101 and 0.184 mm2/s × 10-3 mm2/s: the mean difference in gCC was 0.101 × 10-3 mm2/s with 95% limits of agreement that included the possibility of no difference, but there was significant disagreement in MD values measured in the CSTs. CONCLUSION Agreement between dMRI measures of neonatal WM microstructure calculated from ROI and whole tract averaged methods is weak. ROI approaches may not provide sufficient representation of tract microstructure at the level of neural systems in newborns.
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Affiliation(s)
- Sarah A Sparrow
- MRC Centre for Reproductive Health, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Devasuda Anblagan
- Centre for Clinical Brain Sciences, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Amanda J Drake
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Emma J Telford
- MRC Centre for Reproductive Health, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Rozalia Pataky
- MRC Centre for Reproductive Health, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Chinthika Piyasena
- MRC Centre for Reproductive Health, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK; University/BHF Centre for Cardiovascular Science, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Scott I Semple
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK; Clinical Research Imaging Centre, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Mark E Bastin
- Centre for Clinical Brain Sciences, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - James P Boardman
- MRC Centre for Reproductive Health, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK; Centre for Clinical Brain Sciences, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
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9
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Pecheva D, Kelly C, Kimpton J, Bonthrone A, Batalle D, Zhang H, Counsell SJ. Recent advances in diffusion neuroimaging: applications in the developing preterm brain. F1000Res 2018; 7. [PMID: 30210783 PMCID: PMC6107996 DOI: 10.12688/f1000research.15073.1] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/17/2018] [Indexed: 12/13/2022] Open
Abstract
Measures obtained from diffusion-weighted imaging provide objective indices of white matter development and injury in the developing preterm brain. To date, diffusion tensor imaging (DTI) has been used widely, highlighting differences in fractional anisotropy (FA) and mean diffusivity (MD) between preterm infants at term and healthy term controls; altered white matter development associated with a number of perinatal risk factors; and correlations between FA values in the white matter in the neonatal period and subsequent neurodevelopmental outcome. Recent developments, including neurite orientation dispersion and density imaging (NODDI) and fixel-based analysis (FBA), enable white matter microstructure to be assessed in detail. Constrained spherical deconvolution (CSD) enables multiple fibre populations in an imaging voxel to be resolved and allows delineation of fibres that traverse regions of fibre-crossings, such as the arcuate fasciculus and cerebellar–cortical pathways. This review summarises DTI findings in the preterm brain and discusses initial findings in this population using CSD, NODDI, and FBA.
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Affiliation(s)
- Diliana Pecheva
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Christopher Kelly
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Jessica Kimpton
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Alexandra Bonthrone
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Dafnis Batalle
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Hui Zhang
- Department of Computer Science & Centre for Medical Image Computing, University College London, London, UK
| | - Serena J Counsell
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
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10
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Son S, Kang SH, Lee NM, Kim DK, Seo KM, Ro HJ. Sustained disconnection in sensorimotor pathways results in poor motor function outcome in a term infant after severe white matter injury: A case report. Medicine (Baltimore) 2018; 97:e11585. [PMID: 30075529 PMCID: PMC6081164 DOI: 10.1097/md.0000000000011585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION We report a case of an infant with severe white matter injury (WMI), which was serially evaluated using diffusion tensor imaging (DTI). CASE PRESENTATION A male infant showed decreased muscle tone and weak breathing. A brain magnetic resonance imaging (MRI) 10 days after birth (first study) revealed diffuse microhemorrhages and encephalomalacia. DTI revealed lack of reconstruction of corticospinal tract (CSTs), minimal reconstruction of medial lemniscus, and related thalamocortical pathways (MLs) from the brain stem to the internal capsule level on the left side. The spinothalamic tract and related thalamocortical pathways (STTs) were reconstructed from the brain stem to the internal capsule level bilaterally. The second study one year later showed the absence of reconstruction of CSTs, but reconstruction of MLs and STTS from the brain stem to above the internal capsule showed increased visualization. The third study 3 years later still showed the absence of CSTs reconstruction and MLs and STTs showed no changes from the second study. During this 3-year observation period, the patient showed minimal motor development, and was unable to walk independently, although Gross Motor Function Measure (GMFM) scores were slightly increased. LESSONS Sustained disconnection of major sensorimotor pathways after WMI confirmed by DTI was used to predict motor function outcome.
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Affiliation(s)
- Sunhan Son
- Department of Physical Medicine and Rehabilitation
| | - Si Hyun Kang
- Department of Physical Medicine and Rehabilitation
| | - Na Mi Lee
- Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea
| | - Don-Kyu Kim
- Department of Physical Medicine and Rehabilitation
| | | | - Hee Joon Ro
- Department of Physical Medicine and Rehabilitation
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11
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Teli R, Hay M, Hershey A, Kumar M, Yin H, Parikh NA. Postnatal Microstructural Developmental Trajectory of Corpus Callosum Subregions and Relationship to Clinical Factors in Very Preterm Infants. Sci Rep 2018; 8:7550. [PMID: 29765059 PMCID: PMC5954149 DOI: 10.1038/s41598-018-25245-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 04/13/2018] [Indexed: 11/30/2022] Open
Abstract
Our objectives were to define the microstructural developmental trajectory of six corpus callosum subregions and identify perinatal clinical factors that influence early development of these subregions in very preterm infants. We performed a longitudinal cohort study of very preterm infants (32 weeks gestational age or younger) (N = 36) who underwent structural MRI and diffusion tensor imaging serially at four time points - before 32, 32, 38, and 52 weeks postmenstrual age. We divided the corpus callosum into six subregions, performed probabilistic tractography, and used linear mixed effects models to evaluate the influence of antecedent clinical factors on its microstructural growth trajectory. The genu and splenium demonstrated the most rapid developmental maturation, exhibited by a steep increase in fractional anisotropy. We identified several factors that favored greater corpus callosum microstructural development, including advancing postmenstrual age, higher birth weight, and college level or higher maternal education. Bronchopulmonary dysplasia, low 5-minute Apgar scores, caffeine therapy/apnea of prematurity and male sex were associated with reduced corpus callosum microstructural integrity/development over the first six months after very preterm birth. We identified a unique postnatal microstructural growth trajectory and associated clinical factor profile for each of the six corpus callosum subregions that is consistent with the heterogeneous functional role of these white matter subregions.
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Affiliation(s)
- Radhika Teli
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
| | - Margaret Hay
- Center for Perinatal Research, Nationwide Children's Hospital, Columbus, Ohio, United States of America
| | - Alexa Hershey
- Center for Perinatal Research, Nationwide Children's Hospital, Columbus, Ohio, United States of America
| | - Manoj Kumar
- Center for Perinatal Research, Nationwide Children's Hospital, Columbus, Ohio, United States of America
| | - Han Yin
- Center for Perinatal Research, Nationwide Children's Hospital, Columbus, Ohio, United States of America
| | - Nehal A Parikh
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America. .,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America. .,Center for Perinatal Research, Nationwide Children's Hospital, Columbus, Ohio, United States of America.
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12
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Glozman T, Bruckert L, Pestilli F, Yecies DW, Guibas LJ, Yeom KW. Framework for shape analysis of white matter fiber bundles. Neuroimage 2018; 167:466-477. [PMID: 29203454 PMCID: PMC5845796 DOI: 10.1016/j.neuroimage.2017.11.052] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/26/2017] [Accepted: 11/22/2017] [Indexed: 12/24/2022] Open
Abstract
Diffusion imaging coupled with tractography algorithms allows researchers to image human white matter fiber bundles in-vivo. These bundles are three-dimensional structures with shapes that change over time during the course of development as well as in pathologic states. While most studies on white matter variability focus on analysis of tissue properties estimated from the diffusion data, e.g. fractional anisotropy, the shape variability of white matter fiber bundle is much less explored. In this paper, we present a set of tools for shape analysis of white matter fiber bundles, namely: (1) a concise geometric model of bundle shapes; (2) a method for bundle registration between subjects; (3) a method for deformation estimation. Our framework is useful for analysis of shape variability in white matter fiber bundles. We demonstrate our framework by applying our methods on two datasets: one consisting of data for 6 normal adults and another consisting of data for 38 normal children of age 11 days to 8.5 years. We suggest a robust and reproducible method to measure changes in the shape of white matter fiber bundles. We demonstrate how this method can be used to create a model to assess age-dependent changes in the shape of specific fiber bundles. We derive such models for an ensemble of white matter fiber bundles on our pediatric dataset and show that our results agree with normative human head and brain growth data. Creating these models for a large pediatric longitudinal dataset may improve understanding of both normal development and pathologic states and propose novel parameters for the examination of the pediatric brain.
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Affiliation(s)
- Tanya Glozman
- Electrical Engineering, Stanford University, Stanford, CA, USA.
| | | | - Franco Pestilli
- Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Derek W Yecies
- Pediatric Neurosurgery, Stanford University, Stanford, CA, USA
| | | | - Kristen W Yeom
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, USA
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13
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Pecheva D, Yushkevich P, Batalle D, Hughes E, Aljabar P, Wurie J, Hajnal JV, Edwards AD, Alexander DC, Counsell SJ, Zhang H. A tract-specific approach to assessing white matter in preterm infants. Neuroimage 2017; 157:675-694. [PMID: 28457976 PMCID: PMC5607355 DOI: 10.1016/j.neuroimage.2017.04.057] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/12/2017] [Accepted: 04/25/2017] [Indexed: 11/23/2022] Open
Abstract
Diffusion-weighted imaging (DWI) is becoming an increasingly important tool for studying brain development. DWI analyses relying on manually-drawn regions of interest and tractography using manually-placed waypoints are considered to provide the most accurate characterisation of the underlying brain structure. However, these methods are labour-intensive and become impractical for studies with large cohorts and numerous white matter (WM) tracts. Tract-specific analysis (TSA) is an alternative WM analysis method applicable to large-scale studies that offers potential benefits. TSA produces a skeleton representation of WM tracts and projects the group's diffusion data onto the skeleton for statistical analysis. In this work we evaluate the performance of TSA in analysing preterm infant data against results obtained from native space tractography and tract-based spatial statistics. We evaluate TSA's registration accuracy of WM tracts and assess the agreement between native space data and template space data projected onto WM skeletons, in 12 tracts across 48 preterm neonates. We show that TSA registration provides better WM tract alignment than a previous protocol optimised for neonatal spatial normalisation, and that TSA projects FA values that match well with values derived from native space tractography. We apply TSA for the first time to a preterm neonatal population to study the effects of age at scan on WM tracts around term equivalent age. We demonstrate the effects of age at scan on DTI metrics in commissural, projection and association fibres. We demonstrate the potential of TSA for WM analysis and its suitability for infant studies involving multiple tracts. Evaluation of tract-specific analysis (TSA) for white matter studies in infants. TSA improves white matter tract alignment over scalar-based registration. TSA closely approximates native space tractography DTI values. The first application of TSA to a neonatal population.
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Affiliation(s)
- Diliana Pecheva
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK; Department of Computer Science and Centre for Medical Image Computing, University College London, UK
| | - Paul Yushkevich
- Penn Image Computing and Science Laboratory (PISCL), Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Dafnis Batalle
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK
| | - Emer Hughes
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK
| | - Paul Aljabar
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK
| | - Julia Wurie
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK
| | - Joseph V Hajnal
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK
| | - A David Edwards
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK
| | - Daniel C Alexander
- Department of Computer Science and Centre for Medical Image Computing, University College London, UK
| | - Serena J Counsell
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK.
| | - Hui Zhang
- Department of Computer Science and Centre for Medical Image Computing, University College London, UK
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14
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Zhong J, Chen DQ, Walker M, Waspe A, Looi T, Piorkowska K, Drake JM, Hodaie M. An In vivo Multi-Modal Structural Template for Neonatal Piglets Using High Angular Resolution and Population-Based Whole-Brain Tractography. Front Neuroanat 2016; 10:92. [PMID: 27729850 PMCID: PMC5037218 DOI: 10.3389/fnana.2016.00092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/14/2016] [Indexed: 11/13/2022] Open
Abstract
An increasing number of applications use the postnatal piglet model in neuroimaging studies, however, these are based primarily on T1 weighted image templates. There is a growing need for a multimodal structural brain template for a comprehensive depiction of the piglet brain, particularly given the growing applications of diffusion weighted imaging for characterizing tissue microstructures and white matter organization. In this study, we present the first multimodal piglet structural brain template which includes a T1 weighted image with tissue segmentation probability maps, diffusion weighted metric templates with multiple diffusivity maps, and population-based whole-brain fiber tracts for postnatal piglets. These maps provide information about the integrity of white matter that is not available in T1 images alone. The availability of this diffusion weighted metric template will contribute to the structural imaging analysis of the postnatal piglet brain, especially models that are designed for the study of white matter diseases. Furthermore, the population-based whole-brain fiber tracts permit researchers to visualize the white matter connections in the piglet brain across subjects, guiding the delineation of a specific white matter region for structural analysis where current diffusion data is lacking. Researchers are able to augment the tracts by merging tracts from their own data to the population-based fiber tracts and thus improve the confidence of the population-wise fiber distribution.
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Affiliation(s)
- Jidan Zhong
- Division of Brain, Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute, University Health Network, Toronto ON, Canada
| | - David Q Chen
- Division of Brain, Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute, University Health Network, TorontoON, Canada; Institute of Medical Science, University of Toronto, TorontoON, Canada
| | - Matthew Walker
- Division of Brain, Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute, University Health Network, TorontoON, Canada; Institute of Medical Science, University of Toronto, TorontoON, Canada
| | - Adam Waspe
- Centre for Image Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, Toronto ON, Canada
| | - Thomas Looi
- Centre for Image Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, Toronto ON, Canada
| | - Karolina Piorkowska
- Centre for Image Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, Toronto ON, Canada
| | - James M Drake
- Centre for Image Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, TorontoON, Canada; Division of Neurosurgery, The Hospital for Sick Children, TorontoON, Canada
| | - Mojgan Hodaie
- Division of Brain, Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute, University Health Network, TorontoON, Canada; Institute of Medical Science, University of Toronto, TorontoON, Canada; Division of Neurosurgery, Toronto Western Hospital - University of Toronto, TorontoON, Canada
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15
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Li BX, Liu GS, Ling XY, Chen HF, Luo XQ. [Evaluation of white matter myelination in preterm infants using DTI and MRI]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2016; 18:476-481. [PMID: 27324532 PMCID: PMC7389077 DOI: 10.7499/j.issn.1008-8830.2016.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 04/22/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To investigate the features of white matter myelin development in preterm infants using magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). METHODS A total of 31 preterm infants with a gestational age of ≤32 weeks and a birth weight of <1 500 g were enrolled. According to head MRI findings, these infants were divided into preterm group with brain injury (12 infants) and preterm group without brain injury (19 infants). A total of 24 full-term infants were enrolled as control group. Head MRI and DTI were performed at a gestational age or corrected gestational age of 37-40 weeks. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured for the same regions of interest in the three groups. RESULTS The preterm group with brain injury showed a significantly lower FA value of the posterior limb of the internal capsule than the preterm group without brain injury and full-term control group (P<0.05). The preterm groups with and without brain injury showed significantly lower FA values of frontal white matter and lenticular nucleus than the full-term control group (P<0.05). The FA value of occipital white matter showed no significant differences among the three groups (P>0.05). Compared with the full-term control group, the preterm groups with and without brain injury showed significantly higher ADC values of the posterior limb of the internal capsule, lenticular nucleus, occipital white matter, and frontal white matter (P<0.05). CONCLUSIONS After brain injury, preterm infants tend to develop disorder or delay of white matter myelination in the posterior limb of the internal capsule. At a corrected full-term gestational age, the preterm infants with and without brain injury have a lower grade of maturity in periventricular white matter and grey matter than full-term infants.
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Affiliation(s)
- Bing-Xiao Li
- Department of Pediatrics, First Affiliated Hospital, Jinan University, Guangzhou 510630, China.
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16
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Hagmann C, Singer J, Latal B, Knirsch W, Makki M. Regional Microstructural and Volumetric Magnetic Resonance Imaging (MRI) Abnormalities in the Corpus Callosum of Neonates With Congenital Heart Defect Undergoing Cardiac Surgery. J Child Neurol 2016; 31:300-8. [PMID: 26129977 DOI: 10.1177/0883073815591214] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 05/11/2015] [Indexed: 11/17/2022]
Abstract
The purpose of the study is to investigate the structural development of the corpus callosum in term neonates with congenital heart defect before and after surgery using diffusion tensor imaging and 3-dimensional T1-weighted magnetic resonance imaging (MRI). We compared parallel and radial diffusions, apparent diffusion coefficient (ADC), fractional anisotropy, and volume of 5 substructures of the corpus callosum: genu, rostral body, body, isthmus, and splenium. Compared to healthy controls, we found a significantly lower volume of the splenium and total corpus callosum and a higher radial diffusion and lower fractional anisotropy in the splenium of patients presurgery; a lower volume in all substructures in the postsurgery group; higher radial diffusion in the rostral body, body, and splenium; and a higher apparent diffusion coefficient in the splenium of postsurgery patients. Similar fractional anisotropy changes in congenital heart defect patients were reported in preterm infants. Our findings in apparent diffusion coefficient in the splenium of these patients (pre and postsurgery) are comparable to findings in preterm neonates with psychomotor delay. Delayed maturation of the isthmus was also reported in preterm infants.
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Affiliation(s)
- Cornelia Hagmann
- Department of Neonatology, University Hospital, Zurich, Switzerland
| | - Jitka Singer
- Department of Neonatology, University Hospital, Zurich, Switzerland
| | - Beatrice Latal
- Child Development Center, University Children's Hospital, Zurich, Switzerland
| | - Walter Knirsch
- Pediatric Cardiology, University Children's Hospital, Zurich, Switzerland
| | - Malek Makki
- MRI Research Centre, University Children's Hospital, Zurich, Switzerland
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17
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Tyan AE, McKinney AM, Hanson TJ, Truwit CL. Comparison of spin-echo and gradient-echo T1-weighted and spin-echo T2-weighted images at 3T in evaluating term-neonatal myelination. AJNR Am J Neuroradiol 2015; 36:411-6. [PMID: 25213882 DOI: 10.3174/ajnr.a4099] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARY A prior clinical report of 3T MR imaging in subsequently healthy very premature neonates imaged at term-equivalent age found that both gradient recalled-echo-T1WI and spin-echo-T2WI showed higher rates of myelinated structures, compared with spin-echo-T1WI. The current study set out to assess those rates on the same sequences at 3T in term neonates and thus consisted of 16 term neonates with normal-appearing MR imaging findings who subsequently had normal findings at clinical follow-up. Two neuroradiologists independently assessed 19 structures in those infants on all 3 sequences. Gradient recalled-echo-T1WI showed a slightly higher rate of myelination (57.2%-72.4% of all structures) and interobserver agreement (κ = 0.546, P < .0001) than spin-echo-T2WI (58.2%-64.8%; κ = 0.468, P < .0001), while spin-echo-T1WI had the lowest myelination rate and agreement (25.0%-48.4%; κ = 0.384, P < .0001). Both observers noted that the following structures were myelinated in 88%-100% of patients on gradient recalled-echo-T1WI: the brachium of the inferior colliculus, decussation of the superior cerebellar peduncle, habenular commissure, medial lemniscus, pyramidal decussation, posterior limb of the internal capsule, and superior cerebellar peduncle; on spin-echo-T2WI, there was myelination in 88%-100% of the following structures: the brachium of the inferior colliculus, decussation of the superior cerebellar peduncle, inferior cerebellar peduncle, medial lemniscus, and posterior limb of the internal capsule. In conclusion, this study confirmed that similar to the findings in term-equivalent-age premature infants, myelination changes in term neonates may be best assessed on both gradient recalled-echo-T1WI and spin-echo-T2WI at 3T, and not on spin-echo-T1WI.
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Affiliation(s)
- A E Tyan
- From the Department of Radiology, University of Minnesota-Fairview and Hennepin County Medical Centers, Minneapolis, Minnesota
| | - A M McKinney
- From the Department of Radiology, University of Minnesota-Fairview and Hennepin County Medical Centers, Minneapolis, Minnesota.
| | - T J Hanson
- From the Department of Radiology, University of Minnesota-Fairview and Hennepin County Medical Centers, Minneapolis, Minnesota
| | - C L Truwit
- From the Department of Radiology, University of Minnesota-Fairview and Hennepin County Medical Centers, Minneapolis, Minnesota
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18
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Pieterman K, Plaisier A, Govaert P, Leemans A, Lequin MH, Dudink J. Data quality in diffusion tensor imaging studies of the preterm brain: a systematic review. Pediatr Radiol 2015; 45:1372-81. [PMID: 25820411 PMCID: PMC4526590 DOI: 10.1007/s00247-015-3307-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 01/15/2015] [Accepted: 02/05/2015] [Indexed: 01/31/2023]
Abstract
BACKGROUND To study early neurodevelopment in preterm infants, evaluation of brain maturation and injury is increasingly performed using diffusion tensor imaging, for which the reliability of underlying data is paramount. OBJECTIVE To review the literature to evaluate acquisition and processing methodology in diffusion tensor imaging studies of preterm infants. MATERIALS AND METHODS We searched the Embase, Medline, Web of Science and Cochrane databases for relevant papers published between 2003 and 2013. The following keywords were included in our search: prematurity, neuroimaging, brain, and diffusion tensor imaging. RESULTS We found 74 diffusion tensor imaging studies in preterm infants meeting our inclusion criteria. There was wide variation in acquisition and processing methodology, and we found incomplete reporting of these settings. Nineteen studies (26%) reported the use of neonatal hardware. Data quality assessment was not reported in 13 (18%) studies. Artefacts-correction and data-exclusion was not reported in 33 (45%) and 18 (24%) studies, respectively. Tensor estimation algorithms were reported in 56 (76%) studies but were often suboptimal. CONCLUSION Diffusion tensor imaging acquisition and processing settings are incompletely described in current literature, vary considerably, and frequently do not meet the highest standards.
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Affiliation(s)
- Kay Pieterman
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center - Sophia, dr. Molewaterplein 60, 3015, GJ, Rotterdam, The Netherlands,
| | - Annemarie Plaisier
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center – Sophia, dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands ,Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Paul Govaert
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center – Sophia, dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands ,Department of Pediatrics, Koningin Paola Children’s Hospital, Antwerp, Belgium
| | - Alexander Leemans
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maarten H. Lequin
- Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jeroen Dudink
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center – Sophia, dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands ,Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
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19
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Broekman BFP, Wang C, Li Y, Rifkin-Graboi A, Saw SM, Chong YS, Kwek K, Gluckman PD, Fortier MV, Meaney MJ, Qiu A. Gestational age and neonatal brain microstructure in term born infants: a birth cohort study. PLoS One 2014; 9:e115229. [PMID: 25535959 PMCID: PMC4275243 DOI: 10.1371/journal.pone.0115229] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 11/20/2014] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Understanding healthy brain development in utero is crucial in order to detect abnormal developmental trajectories due to developmental disorders. However, in most studies neuroimaging was done after a significant postnatal period, and in those studies that performed neuroimaging on fetuses, the quality of data has been affected due to complications of scanning during pregnancy. To understand healthy brain development between 37-41 weeks of gestational age, our study assessed the in utero growth of the brain in healthy term born babies with DTI scanning soon after birth. METHODS A cohort of 93 infants recruited from maternity hospitals in Singapore underwent diffusion tensor imaging between 5 to 17 days after birth. We did a cross-sectional examination of white matter microstructure of the brain among healthy term infants as a function of gestational age via voxel-based analysis on fractional anisotropy. RESULTS Greater gestational age at birth in term infants was associated with larger fractional anisotropy values in early developing brain regions, when corrected for age at scan. Specifically, it was associated with a cluster located at the corpus callosum (corrected p<0.001), as well as another cluster spanning areas of the anterior corona radiata, anterior limb of internal capsule, and external capsule (corrected p<0.001). CONCLUSIONS Our findings show variation in brain maturation associated with gestational age amongst 'term' infants, with increased brain maturation when born with a relatively higher gestational age in comparison to those infants born with a relatively younger gestational age. Future studies should explore if these differences in brain maturation between 37 and 41 weeks of gestational age will persist over time due to development outside the womb.
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Affiliation(s)
- Birit F. P. Broekman
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
- Singapore Institute for Clinical Sciences, the Agency for Science, Technology and Research, Singapore, Singapore
| | - Changqing Wang
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
| | - Yue Li
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
| | - Anne Rifkin-Graboi
- Singapore Institute for Clinical Sciences, the Agency for Science, Technology and Research, Singapore, Singapore
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - Kenneth Kwek
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Peter D. Gluckman
- Singapore Institute for Clinical Sciences, the Agency for Science, Technology and Research, Singapore, Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Marielle V. Fortier
- Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Michael J. Meaney
- Singapore Institute for Clinical Sciences, the Agency for Science, Technology and Research, Singapore, Singapore
- Departments of Psychiatry and Neurology & Neurosurgery, McGill University, Montreal, Canada
| | - Anqi Qiu
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, the Agency for Science, Technology and Research, Singapore, Singapore
- Clinical Imaging Research Centre, National University of Singapore, Singapore, Singapore
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20
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Pannek K, Scheck SM, Colditz PB, Boyd RN, Rose SE. Magnetic resonance diffusion tractography of the preterm infant brain: a systematic review. Dev Med Child Neurol 2014; 56:113-24. [PMID: 24102176 DOI: 10.1111/dmcn.12250] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/07/2013] [Indexed: 12/13/2022]
Abstract
AIM Preterm birth is associated with an increased risk of adverse neurodevelopmental outcomes. Diffusion magnetic resonance imaging (dMRI) combined with tractography can be used to assess non-invasively white matter microstructure and brain development in preterm infants. Our aim was to conduct a systematic review of the current evidence obtained from tractography studies of preterm infants in whom MRI was performed up to term-equivalent age. METHOD Databases were searched for dMRI tractography studies of preterm infants. RESULTS Twenty-two studies were assessed. The most frequently assessed tracts included the corticospinal tract, the corpus callosum, and the optic radiations. The superior longitudinal fasciculus, and the anterior and superior thalamic radiations were investigated less frequently. A clear relationship exists between diffusion metrics and postmenstrual age at the time of scanning, although the evidence of an effect of gestational age at birth and white matter injury is conflicting. Sex and laterality may play an important role in the relationship between diffusion metrics, early clinical assessment, and outcomes. INTERPRETATION Studies involving infants of all gestational ages are required to elucidate the relationship between gestational age and diffusion metrics, and to establish the utility of tractography as a predictive tool. There is a need for more robust acquisition and analysis methods to improve the accuracy of assessing development of white matter pathways.
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Affiliation(s)
- Kerstin Pannek
- School of Medicine, The University of Queensland, Brisbane, Qld;, Australia
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21
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Kaur S, Powell S, He L, Pierson CR, Parikh NA. Reliability and repeatability of quantitative tractography methods for mapping structural white matter connectivity in preterm and term infants at term-equivalent age. PLoS One 2014; 9:e85807. [PMID: 24475054 PMCID: PMC3901659 DOI: 10.1371/journal.pone.0085807] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 12/03/2013] [Indexed: 01/08/2023] Open
Abstract
Premature infants exhibit widespread insults and delays in white matter maturation that can be sensitively detected early using diffusion tensor imaging. Diffusion tensor tractography facilitates in vivo visualization of white matter tracts and has the potential to be more sensitive than simpler two-dimensional DTI-based measures. However, the reliability and reproducibility of performing tractography for major white matter tracts in preterm infants is not known. The main objective of our study was to develop highly reliable and repeatable methods for ten white matter tracts in extremely low birth weight infants (birth weight ≤ 1000 g) at term-equivalent age. To demonstrate clinical utility, we also compared fiber microstructural and macrostructural parameters between preterm and healthy term controls. Twenty-nine ELBW infants and a control group of 15 healthy term newborns were studied. A team of researchers experienced in neuroanatomy/neuroimaging established the manual segmentation protocol based on a priori anatomical knowledge and an extensive training period to identify sources of variability. Intra- and inter-rater reliability and repeatability was tested using intra-class correlation coefficient, within-subject standard deviation (SD), repeatability, and Dice similarity index. Our results support our primary goal of developing highly reliable and reproducible comprehensive methods for manual segmentation of 10 white matter tracts in ELBW infants. The within-subject SD was within 1-2% and repeatability within 3-7% of the mean values for all 10 tracts. The intra-rater Dice index was excellent with a range of 0.97 to 0.99, and as expected, the inter-rater Dice index was lower (range: 0.80 to 0.91), but still within a very good reliability range. ELBW infants exhibited fewer fiber numbers and/or abnormal microstructure in a majority of the ten quantified tracts, consistent with injury/delayed development. This protocol could serve as a valuable tool for prompt evaluation of the impact of neuroprotective therapies and as a prognostic biomarker for neurodevelopmental impairments.
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Affiliation(s)
- Supreet Kaur
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, United States of America
| | - Samuel Powell
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, United States of America
| | - Lili He
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, United States of America
| | - Christopher R. Pierson
- Departments of Pediatrics and Pathology, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, United States of America
| | - Nehal A. Parikh
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, United States of America
- Departments of Pediatrics and Pathology, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
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Rose J, Vassar R, Cahill-Rowley K, Guzman XS, Stevenson DK, Barnea-Goraly N. Brain microstructural development at near-term age in very-low-birth-weight preterm infants: an atlas-based diffusion imaging study. Neuroimage 2013; 86:244-56. [PMID: 24091089 DOI: 10.1016/j.neuroimage.2013.09.053] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 08/19/2013] [Accepted: 09/22/2013] [Indexed: 10/26/2022] Open
Abstract
At near-term age the brain undergoes rapid growth and development. Abnormalities identified during this period have been recognized as potential predictors of neurodevelopment in children born preterm. This study used diffusion tensor imaging (DTI) to examine white matter (WM) microstructure in very-low-birth-weight (VLBW) preterm infants to better understand regional WM developmental trajectories at near-term age. DTI scans were analyzed in a cross-sectional sample of 45 VLBW preterm infants (BW≤1500g, GA≤32weeks) within a cohort of 102 neonates admitted to the NICU and recruited to participate prior to standard-of-care MRI, from 2010 to 2011, 66/102 also had DTI. For inclusion in this analysis, 45 infants had DTI, no evidence of brain abnormality on MRI, and were scanned at PMA ≤40weeks (34.7-38.6). White matter microstructure was analyzed in 19 subcortical regions defined by DiffeoMap neonatal brain atlas, using threshold values of trace <0.006mm(2)s(-1) and FA >0.15. Regional fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were calculated and temporal-spatial trajectories of development were examined in relation to PMA and brain region location. Posterior regions within the corona radiata (CR), corpus callosum (CC), and internal capsule (IC) demonstrated significantly higher mean FA values compared to anterior regions. Posterior regions of the CR and IC demonstrated significantly lower RD values compared to anterior regions. Centrally located projection fibers demonstrated higher mean FA and lower RD values than peripheral regions including the posterior limb of the internal capsule (PLIC), cerebral peduncle, retrolenticular part of the IC, posterior thalamic radiation, and sagittal stratum. Centrally located association fibers of the external capsule had higher FA and lower RD than the more peripherally-located superior longitudinal fasciculus (SLF). A significant relationship between PMA-at-scan and FA, MD, and RD was demonstrated by a majority of regions, the strongest correlations were observed in the anterior limb of the internal capsule, a region undergoing early stages of myelination at near-term age, in which FA increased (r=.433, p=.003) and MD (r=-.545, p=.000) and RD (r=-.540, p=.000) decreased with PMA-at-scan. No correlation with PMA-at-scan was observed in the CC or SLF, regions that myelinate later in infancy. Regional patterns of higher FA and lower RD were observed at this near-term age, suggestive of more advanced microstructural development in posterior compared to anterior regions within the CR, CC, and IC and in central compared to peripheral WM structures. Evidence of region-specific rates of microstructural development was observed. Temporal-spatial patterns of WM microstructure development at near-term age have important implications for interpretation of near-term DTI and for identification of aberrations in typical developmental trajectories that may signal future impairment.
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Affiliation(s)
- Jessica Rose
- Department of Orthopaedic Surgery, Stanford University School of Medicine, USA; Motion Analysis Lab, Lucile Packard Children's Hospital, USA.
| | - Rachel Vassar
- Department of Orthopaedic Surgery, Stanford University School of Medicine, USA
| | - Katelyn Cahill-Rowley
- Motion Analysis Lab, Lucile Packard Children's Hospital, USA; Department of BioEngineering, Stanford, CA, USA
| | - Ximena Stecher Guzman
- Radiology Department, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Chile
| | - David K Stevenson
- Division of Neonatology and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Naama Barnea-Goraly
- Center for Interdisciplinary Brain Sciences Research, Stanford University School of Medicine, USA
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Ling X, Tang W, Liu G, Huang L, Li B, Li X, Liu S, Xu J. Assessment of brain maturation in the preterm infants using diffusion tensor imaging (DTI) and enhanced T2 star weighted angiography (ESWAN). Eur J Radiol 2013; 82:e476-83. [DOI: 10.1016/j.ejrad.2013.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 03/01/2013] [Accepted: 04/01/2013] [Indexed: 10/26/2022]
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Pannek K, Hatzigeorgiou X, Colditz PB, Rose S. Assessment of structural connectivity in the preterm brain at term equivalent age using diffusion MRI and T2 relaxometry: a network-based analysis. PLoS One 2013; 8:e68593. [PMID: 23950872 PMCID: PMC3737239 DOI: 10.1371/journal.pone.0068593] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 06/01/2013] [Indexed: 12/05/2022] Open
Abstract
Preterm birth is associated with a high prevalence of adverse neurodevelopmental outcome. Non-invasive techniques which can probe the neural correlates underpinning these deficits are required. This can be achieved by measuring the structural network of connections within the preterm infant's brain using diffusion MRI and tractography. We used diffusion MRI and T2 relaxometry to identify connections with altered white matter properties in preterm infants compared to term infants. Diffusion and T2 data were obtained from 9 term neonates and 18 preterm-born infants (born <32 weeks gestational age) at term equivalent age. Probabilistic tractography incorporating multiple fibre orientations was used in combination with the Johns Hopkins neonatal brain atlas to calculate the structural network of connections. Connections of altered diffusivity or T2, as well as their relationship with gestational age at birth and postmenstrual age at the time of MRI, were identified using the network based statistic framework. A total of 433 connections were assessed. FA was significantly reduced in 17, and T2 significantly increased in 18 connections in preterm infants, following correction for multiple comparisons. Cortical networks associated with affected connections mainly involved left frontal and temporal cortical areas: regions which are associated with working memory, verbal comprehension and higher cognitive function – deficits which are often observed later in children and adults born preterm. Gestational age at birth correlated with T2, but not diffusion in several connections. We found no association between diffusion or T2 and postmenstrual age at the time of MRI in preterm infants. This study demonstrates that alterations in the structural network of connections can be identified in preterm infants at term equivalent age, and that incorporation of non-diffusion measures such as T2 in the connectome framework provides complementary information for the assessment of brain development.
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Affiliation(s)
- Kerstin Pannek
- The University of Queensland, School of Medicine, Brisbane, Australia
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Brisbane, Australia
| | - Xanthy Hatzigeorgiou
- The University of Queensland, Perinatal Research Centre, Brisbane, Australia
- The University of Queensland and Royal Children's Hospital, Children's Nutrition Research Centre, Brisbane, Australia
| | - Paul B. Colditz
- The University of Queensland, Perinatal Research Centre, Brisbane, Australia
- The University of Queensland, Centre for Clinical Research, Brisbane, Australia
| | - Stephen Rose
- The Australian e-Health Research Centre, CSIRO, Brisbane, Australia
- * E-mail:
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25
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Pavlova MA, Krägeloh-Mann I. Limitations on the developing preterm brain: impact of periventricular white matter lesions on brain connectivity and cognition. ACTA ACUST UNITED AC 2013; 136:998-1011. [PMID: 23550112 DOI: 10.1093/brain/aws334] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Brain lesions to the white matter in peritrigonal regions, periventricular leukomalacia, in children who were born prematurely represent an important model for studying limitations on brain development. The lesional pattern is of early origin and bilateral, that constrains the compensatory potential of the brain. We suggest that (i) topography and severity of periventricular lesions may have a long-term predictive value for cognitive and social capabilities in preterm birth survivors; and (ii) periventricular lesions may impact cognitive and social functions by affecting brain connectivity, and thereby, the dissociable neural networks underpinning these functions. A further pathway to explore is the relationship between cerebral palsy and cognitive outcome. Restrictions caused by motor disability may affect active exploration of surrounding and social participation that may in turn differentially impinge on cognitive development and social cognition. As an outline for future research, we underscore sex differences, as the sex of a preterm newborn may shape the mechanisms by which the developing brain is affected.
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Affiliation(s)
- Marina A Pavlova
- Department of Paediatric Neurology and Developmental Medicine, Children's Hospital, Medical School, Eberhard Karls University of Tübingen, Hoppe-Seyler-Strasse 1, 72076 Tübingen, Germany.
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26
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De Bruïne FT, Van Wezel-Meijler G, Leijser LM, Steggerda SJ, Van Den Berg-Huysmans AA, Rijken M, Van Buchem MA, Van Der Grond J. Tractography of white-matter tracts in very preterm infants: a 2-year follow-up study. Dev Med Child Neurol 2013; 55:427-33. [PMID: 23441853 DOI: 10.1111/dmcn.12099] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/20/2012] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to determine whether tractography of white-matter tracts can independently predict neurodevelopmental outcome in very preterm infants. METHOD Out of 84 very preterm infants admitted to a neonatal intensive care unit, 64 (41 males, 23 females; median gestational age 29.1 weeks [range 25.6-31.9]; birthweight 1163 g [range 585-1960]) underwent follow-up at 2 years. Diffusion tensor imaging (DTI) values obtained around term were associated with a neurological examination and mental and psychomotor developmental index scores at 2 years based on the Bayley Scales of Infant Development (version 3). Univariate and logistic regression analyses tested for associations between DTI values and follow-up parameters. Cut-off values predicting motor delay and cerebral palsy (CP) were determined for fractional anisotropy, apparent diffusion coefficient (ADC), and fibre lengths. RESULTS Infants with psychomotor delay and CP had significantly lower fractional anisotropy values (p=0.002, p=0.04 respectively) and shorter fibre lengths (p=0.02, p=0.02 respectively) of the posterior limb of the internal capsule. Infants with psychomotor delay also had significantly higher ADC values (p=0.03) and shorter fibre lengths (p=0.002) of the callosal splenium. Fractional anisotropy values of the posterior limb of the internal capsule independently predicted motor delay and CP, with sensitivity between 80 and 100% and specificity between 66 and 69%. ADC values of the splenium independently predicted motor delay with sensitivity of 100% and specificity of 65%. INTERPRETATION Diffusion tensor imaging tractography at term-equivalent age independently predicts psychomotor delay at 2 years of age in preterm infants.
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27
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Heemskerk AM, Leemans A, Plaisier A, Pieterman K, Lequin MH, Dudink J. Acquisition guidelines and quality assessment tools for analyzing neonatal diffusion tensor MRI data. AJNR Am J Neuroradiol 2013; 34:1496-505. [PMID: 23518355 DOI: 10.3174/ajnr.a3465] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Diffusion tensor imaging is a valuable measure in clinical settings to assess diagnosis and prognosis of neonatal brain development. However, obtaining reliable images is not straightforward because of the tissue characteristics of the neonatal brain and the high likelihood of motion artifacts. In this review, we present guidelines on how to acquire DTI data of the neonatal brain and recommend high-quality data acquisition and processing as an essential means to obtain accurate and robust parametric maps. Sudden head movements are problematic for DTI in neonates, and these may lead to incorrect values. We describe strategies to minimize the corrupting effects both in terms of acquisition (eg, more gradient directions) and postprocessing (eg, tensor estimation methods). In addition, tools are described that can help assess whether a dataset is of sufficient quality for further assessment.
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Affiliation(s)
- A M Heemskerk
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
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28
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Ball G, Boardman JP, Aljabar P, Pandit A, Arichi T, Merchant N, Rueckert D, Edwards AD, Counsell SJ. The influence of preterm birth on the developing thalamocortical connectome. Cortex 2012; 49:1711-21. [PMID: 22959979 DOI: 10.1016/j.cortex.2012.07.006] [Citation(s) in RCA: 153] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 06/20/2012] [Accepted: 07/16/2012] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Defining connectivity in the human brain signifies a major neuroscientific goal. Advanced imaging techniques have enabled the non-invasive tracing of brain networks to define the human connectome on a millimetre-scale. During early development, the brain undergoes significant changes that are likely represented in the developing connectome, and preterm birth represents a significant environmental risk factor that impacts negatively on early cerebral development. Using tractography to comprehensively map the connections of the thalamocortical unit, we aim to demonstrate that premature extrauterine life due to preterm delivery results in significantly decreased thalamocortical connectivity in the developing human neonate. METHODS T1- and T2-weighted magnetic resonance images and 32-direction diffusion tensor images were acquired from 18 healthy term-born neonates (median gestational age: 41(+3)) and 47 preterm infants (median gestational age: 28(+3)) scanned at term-equivalent age. Using a novel processing pipeline for tracing connections in the neonatal brain we map and compare the thalamocortical macro-connectome between groups. RESULTS We demonstrate that connections between the thalamus and the frontal cortices, supplementary motor areas, occipital lobe and temporal gyri are significantly diminished in preterm infants (FDR-corrected, p < .001). CONCLUSIONS This supports the hypothesis that the thalamocortical system is vulnerable following preterm birth and the tractographic framework presented represents a method for analysing system connectivity that can be readily applied to other populations and neural systems.
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Affiliation(s)
- Gareth Ball
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK
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29
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Quantitative brain diffusion-tensor MRI findings in patients with sickle cell disease. AJR Am J Roentgenol 2012; 198:1167-74. [PMID: 22528909 DOI: 10.2214/ajr.11.7404] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the microstructure of various regions of the brain using diffusion-tensor imaging (DTI) in patients with sickle cell disease (SCD) and in age- and sex-matched healthy control subjects. We also investigated the fiber tractography findings of the corpus callosum (CC) and corticospinal tracts (CSTs). SUBJECTS AND METHODS Sixteen right-handed patients with SCD and 14 age- and sex-matched right-handed healthy control subjects were scanned using conventional MR sequences and DTI. Fractional anisotropy (FA) and apparent diffusion coefficients (ADCs) were calculated and regions of interest were selected in various brain areas (superior and inferior frontal, parietal, occipital, and temporal white matter areas), anterior and posterior periventricular areas, centrum semiovale, basal ganglia (lentiform nucleus, head of caudate nucleus), thalamus, cerebral peduncles, pons, cerebellar white matter areas, and CC. Diffusion-tensor tractography of the CC and CSTs was also performed. RESULTS For the patients with SCD, significantly reduced FA values, increased ADC values, or both were seen clustered in several brain areas, including the CC, frontal white matter, centrum semiovale, periventricular areas, head of the caudate nucleus, thalamus, brainstem, and pons (p < 0.05). Statistically significant reductions in fiber counts in the first and fifth segments of the CC and in CSTs bilaterally were also observed in patients with SCD (p < 0.05). CONCLUSION DTI shows microstructural abnormalities of various brain areas in patients with SCD.
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Liu Y, Aeby A, Balériaux D, David P, Absil J, De Maertelaer V, Van Bogaert P, Avni F, Metens T. White matter abnormalities are related to microstructural changes in preterm neonates at term-equivalent age: a diffusion tensor imaging and probabilistic tractography study. AJNR Am J Neuroradiol 2012; 33:839-45. [PMID: 22241389 DOI: 10.3174/ajnr.a2872] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Preterm infants have a high risk of brain injury and neurodevelopmental impairment, often associated with WMA on conventional MR imaging. DTI can provide insight into white matter microstructure. The aim of this study was to investigate the association between WMA on conventional MR imaging and DTI parameters in specific fibers in preterm neonates at term-equivalent age. MATERIALS AND METHODS Seventy preterm neonates (39 boys and 31 girls) were included in the study. WMA were classified as no, mild, moderate, or severe. Probabilistic tractography provided tract volumes, FA, MD, λ(//), and λ(⊥) in the CST, SLF, TRs, and corpus callosum. Data were compared by using MANOVA, and adjustment for multiple comparisons was performed. RESULTS Important associations were found between WMA and microstructural changes. Compared with neonates with no WMA (n = 41), those with mild WMA (n = 27) had significantly increased λ(⊥) and MD in the left ATR, the left sensory STR, the bilateral motor STR, and for λ(⊥) also in the right CST; FA decreased significantly in the left sensory STR. Diminished tract volumes and altered diffusion indices were also observed in the 2 neonates with moderate WMA. CONCLUSIONS Altered DTI indices in specific tracts, with λ(⊥) as most prominent, are associated with mild WMA in preterm neonates at term-equivalent age.
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Affiliation(s)
- Y Liu
- Departments of Radiology, ULB-Hôpital Erasme, Brussels, Belgium.
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31
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Shim SY, Jeong HJ, Son DW, Jeong JS, Oh SH, Park SY, Ryu TH, Kim YB, Cho ZH. Altered microstructure of white matter except the corpus callosum is independent of prematurity. Neonatology 2012; 102:309-15. [PMID: 22986463 DOI: 10.1159/000341867] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 07/16/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) reflects the maturation of the brain microstructure. Although preterm infants are at significant risk for altered brain microstructure, it remains unclear whether this is affected by prematurity itself or other clinical factors. OBJECTIVES To investigate DTI parameters in preterm infants at a term-equivalent age (TEA) compared with healthy term infants and to assess the associations between DTI parameters and clinical factors that may affect brain development. METHODS We studied 34 preterm infants without apparent brain lesions and 12 healthy term infants using tract-based spatial statistics. Region-of-interest analysis was performed in the posterior and anterior limbs of the internal capsule (PLIC and ALIC), corpus callosum (CC), optic radiation, and cerebral peduncle. RESULTS Preterm infants had significantly decreased fractional anisotropy (FA) in nearly the entire white matter (WM) compared with term infants (p < 0.01). Multiple regression analysis showed that FA in the PLIC, ALIC, optic radiation, and cerebral peduncle were positively associated with postmenstrual age (PMA) at imaging and that the apparent diffusion coefficient was negatively associated with PMA. Only FA in the CC was positively correlated with gestational age. Chronic lung disease (CLD) and postnatal infection were associated with decreased FA in the CC and PLIC, respectively. CONCLUSIONS Preterm infants at TEA showed an altered microstructure of the WM compared with healthy term infants. The altered microstructure of the measured WM except the CC was independent of the degree of prematurity. Chronic lung disease and postnatal infection are related to localized WM alterations.
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Affiliation(s)
- So-Yeon Shim
- Division of Neonatology, Gachon University Gil Hospital, Incheon, Korea
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van Pul C, van Kooij BJM, de Vries LS, Benders MJNL, Vilanova A, Groenendaal F. Quantitative fiber tracking in the corpus callosum and internal capsule reveals microstructural abnormalities in preterm infants at term-equivalent age. AJNR Am J Neuroradiol 2011; 33:678-84. [PMID: 22194382 DOI: 10.3174/ajnr.a2859] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Signal-intensity abnormalities in the PLIC and thinning of the CC are often seen in preterm infants and associated with poor outcome. DTI is able to detect subtle abnormalities. We used FT to select bundles of interest (CC and PLIC) to acquire additional information on the WMI. MATERIALS AND METHODS One hundred twenty preterm infants born at <31 weeks' gestation with 3T DTI at TEA entered this prospective study. Quantitative information (ie, volume, length, anisotropy, and MD) was obtained from fiber bundles passing through the PLIC and CC. A general linear model was used to assess the effects of factor (sex) and variables (GA, BW, HC, PMA, and WMI) on FT-segmented parameters. RESULTS Seventy-two CC and 85 PLIC fiber bundles were assessed. For the CC, increasing WMI and decreasing FA (P = .038), bundle volume (P < .001), and length (P = .001) were observed, whereas MD increased (P = .001). For PLIC, MD increased with increasing WMI (P = .002). Higher anisotropy and larger bundle length were observed in the left PLIC compared with the right (P = .003, P = .018). CONCLUSIONS We have shown that in the CC bundle, anisotropy was decreased and diffusivity was increased in infants with high WMI scores. A relation of PLIC with WMI was also shown but was less pronounced. Brain maturation is affected more if birth was more premature.
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Affiliation(s)
- C van Pul
- Department of Neonatology, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, The Netherlands.
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